Predictors of discharges against medical advice from a short-term hospital detoxification unit

The primary goal of this study was to identify factors associated with patients leaving a 3-day hospital detoxification unit against medical advice (AMA). Medical records of 302 patients who were admitted for alcohol or other drug withdrawal were reviewed. Variables examined were: demographics, repo...

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Bibliographic Details
Published in:Drug and alcohol dependence 1999-08, Vol.56 (1), p.1-8
Main Authors: Armenian, Saro H, Chutuape, Mary Ann, Stitzer, Maxine L
Format: Article
Language:English
Subjects:
Adult
Against medical advice
Age Factors
Alcoholism - drug therapy
Alcoholism - urine
Biological and medical sciences
Case-Control Studies
Clonidine
Cocaine-Related Disorders - drug therapy
Cocaine-Related Disorders - urine
Detoxification
Diazepam
Discharge against medical advice
Drug abuse
Female
Heroin Dependence - drug therapy
Heroin Dependence - urine
Hospitalization
Hospitals
Humans
Male
Medical sciences
Mental health
Middle Aged
Opiate abuse
Opiates
Organization of mental health. Health systems
Patient Dropouts
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Regression Analysis
Retrospective Studies
Risk Factors
Social psychiatry. Ethnopsychiatry
Substance Withdrawal Syndrome - drug therapy
Substance Withdrawal Syndrome - urine
Substance-Related Disorders - drug therapy
Substance-Related Disorders - urine
Treatment
USA
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Summary:The primary goal of this study was to identify factors associated with patients leaving a 3-day hospital detoxification unit against medical advice (AMA). Medical records of 302 patients who were admitted for alcohol or other drug withdrawal were reviewed. Variables examined were: demographics, reported history of drug use, urine toxicology at admission, medication received during the detoxification, and admission day. Data were analyzed using a case-control design. Logistic regression was used to identify independent predictors. We found that being younger, having a shorter history of cocaine abuse, being admitted on a Friday and being an opiate dependent patient treated with clonidine only during the detoxification, were significantly associated with leaving AMA. These findings may provide information that can help clinicians identify those patients who are most at risk for leaving AMA. This will in turn allow them the opportunity to initiate preventive measures to decrease unnecessary attrition and improve utilisation of treatment resources.
ISSN:0376-8716
1879-0046
DOI:10.1016/S0376-8716(99)00027-7